What were the characteristics of the 1919-20 pandemic flu, and why was it so much more virulent than typical annual strains?
Modern research has helped scientists find the answer to why the 1918 Great Pandemic killed 675,000 Americans. Most deaths in the 1918 influenza pandemic were due not to the virus alone but to common bacterial infections that took advantage of victims' weakened immune systems, according to two new studies that could change the nation's strategy against the next pandemic. It has recently been found that an over-stimulated immune system was killed even as it tried to fight the flu. This helps explain why many of the 50 million people who died in the epidemic were healthy young adults, because conventional flu usually claims mostly the very young and very old. The U.S. citizens were ordered to wear masks, and schools, theaters and other public places were shuttered. It was recently discovered that the 1918 pandemic was deadly because in many victims, the influenza virus had invaded their lungs and caused pneumonia. This caused their bodies’ defenses to go haywire, not knowing when to stop. The lungs became inflamed and filled with blood and other fluids. Researchers also have found that all viruses possessing 1918's hem agglutinin (HA) and neuraminidase (NA) genes were highly lethal to mice, a somewhat surprising discovery since genes from a human flu strain normally do not cause disease in mice. This can show the severity of the influenza. Also it was not caused by the mice, which are unlike during the trench warfare or the bubonic plague when the mice caused the flu.

To what extent was the spread and the effects of the flu pandemic a consequence of the Great War? Is it possible that without the war the disease would have been just as deadly?
In the fall of 1918 the Great War in Europe was winding down and peace was on the horizon. The Americans had joined in the fight, bringing the Allies closer to victory against the Germans. Deep within the trenches these men lived through some of the most brutal conditions of life, which it seemed could not be any worse. Then, in pockets across the globe, something erupted that seemed as benign as the common cold. An estimated 43,000 servicemen mobilized for WWI died of influenza. The year 1918 would go down as unforgettable year of suffering and death and yet of peace. The American military experience in World War I and the influenza pandemic were closely intertwined. The war fostered influenza in the crowded conditions of military camps in the United States and in the trenches of the Western Front in Europe. The virus traveled with military personnel from camp to camp and across the Atlantic, and at the height of the American military involvement in the war, September through November 1918, influenza and pneumonia sickened 20% to 40% of U.S. Army and Navy personnel. The influenza of that season, however, was far more than a cold. In the two years that this scourge ravaged the earth, a fifth of the world's population was infected. The flu was most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza which is usually a killer of the elderly and young children. It infected 28% of all Americans. An estimated 675,000 Americans died of influenza during the pandemic, ten times as many as in the world war. Of the U.S. soldiers who died in Europe, half of them fell to the influenza virus and not to the enemy. These high morbidity rates interfered with induction and training schedules in the United States and rendered hundreds of thousands of military personnel non-effective. During the American Expeditionary Forces' campaign at Meuse-Argonne, the epidemic diverted urgently needed resources from combat support to transporting and caring for the sick and the dead. Influenza and pneumonia killed more American soldiers and sailors during the war than did enemy weapons. The war would not have been as deadly if it was not for the pandemic of 1918. The influenza killed many soldiers and civilians. Since there were no antibiotics or medicine that could be found to prevent the disease, mean individuals all over the world died.

To what extent were the effects of the flu pandemic attributable to other post-war conditions, such as resumption of peacetime economic activity, revolution, famine, social turmoil, and so on?
Economic Activity
  • Results suggest that one more death per thousand resulted in an average annual increase in the rate of economic growth over the next ten years of at least 0.2 percent per year. This effect is larger than that suggested by simulations using both a standard neoclassical or endogenous AK growth model. However, it is found that flu deaths in 1918 and 1919 among prime-age adults are a significant predictor of business failures in 1919 and 1920. This implies that one reason for the positive association between flu deaths and economic growth from 1919-1921 to 4 1930 is that the epidemic caused substantial business failures which caused the economy to be below trend on average between 1919 and 1921. In other words, some of the growth from 1919-1921 to 1930 is not a change in trend, but only a return to trend after this large temporary shock.
Revolution
  • People allowed for strict measures and loss of freedom during the war as they submitted to the needs of the nation ahead of their personal needs. They had accepted the limitations placed with rationing and drafting. The responses of the public health officials reflected the new allegiance to science and the wartime society. The medical and scientific communities had developed new theories and applied them to prevention, diagnostics and treatment of the influenza patients.
Social Turmoil
  • Even President Woodrow Wilson suffered from the flu in early 1919 while negotiating the crucial treaty of Versailles to end the World War . Those who were lucky enough to avoid infection had to deal with the public health ordinances to restrain the spread of the disease. The public health departments distributed gauze masks to be worn in public. Stores could not hold sales; funerals were limited to 15 minutes. Some towns required a signed certificate to enter and railroads would not accept passengers without them. Those who ignored the flu ordinances had to pay steep fines enforced by extra officers. Bodies piled up as the massive deaths of the epidemic ensued. Besides the lack of health care workers and medical supplies, there was a shortage of coffins, morticians and gravediggers. The conditions in 1918 were not so far removed from the Black Death in the era of the bubonic plague of the Middle Ages.
Technology
  • In 1918-19 this deadly influenza pandemic erupted during the final stages of World War I. Nations were already attempting to deal with the effects and costs of the war. Propaganda campaigns and war restrictions and rations had been implemented by governments. Nationalism pervaded as people accepted government authority. This allowed the public health departments to easily step in and implement their restrictive measures. The war also gave science greater importance as governments relied on scientists, now armed with the new germ theory and the development of antiseptic surgery, to design vaccines and reduce mortalities of disease and battle wounds. Their new technologies could preserve the men on the front and ultimately save the world. These conditions created by World War I, together with the current social attitudes and ideas, led to the relatively calm response of the public and application of scientific ideas.

Bibliography
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  • "Deaths Associated with Influenza Pandemic of 1918–19, Japan - Vol. 19 No. 4 - April 2013 - Emerging Infectious Disease Journal - CDC." Deaths Associated with Influenza Pandemic of 1918–19, Japan - Vol. 19 No. 4 - April 2013 - Emerging Infectious Disease Journal - CDC. N.p., n.d. Web. 07 Oct. 2013.


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